PubMed Health⌕ Search

Biomedical subjects

A Revhaug

Publications and source records attributed to A Revhaug.

At least 55 records · Page 3Linked to original sources
PubMed1995

Metabolic effects of two regimens of growth hormone given before operation in piglets.

OBJECTIVE: To clarify the effects of growth hormone (GH) given three days before and at the start of a standard abdominal operation or at the start of the abdominal operation alone in piglets. DESIGN: Randomised experiment. SETTING: University hospital, Norway SUBJECTS: Twenty-four piglets. INTERVENTIONS: GH 24 IU was given intramuscularly for either three days before and on the morning of the operation or on the morning of a standard abdominal operation only (n = 8 in each group) A further 8 piglets acted as untreated controls. MAIN OUTCOME MEASURES: Diameter of fibres in the soleus and gastrocnemius muscles; urinary nitrogen excretion; and fat and carbohydrate oxidation measured by indirect calorimetry. RESULTS: Nitrogen excretion was reduced (in the three days group the mean (SEM) was 30.8 (4.2) mg/kg, corresponding figures from the one day group and the controls were 37.6 (5.8) and 55.4 (3.1) mg/kg, respectively, p = 0.004). Fat oxidation increased (for the whole period: p = 0.014) and carbohydrate oxidation decreased (p = 0.02) in the one day group only. The diameter of type I muscle fibres was increased in both muscles (soleus, three day group, mean (SEM) 37.5(1.4) microns compared with control, 30.4(0.6) microns, p = 0.001, and gastrocnemius, three day group 38.6(1.3) microns compared with control, 30.8(1.4) microns, p = 0.01). CONCLUSIONS: Three days treatment with GH enhanced nitrogen sparing and attenuated changes in fat and carbohydrate oxidation induced by one day treatment, but induced hypertrophy of type I muscle fibres.

Animals↗
PubMed1995

Intraosseous infusion of a small volume of hyperosmotic fluid increases mean arterial pressure and lessens the catecholamine response in pigs with haemorrhagic shock.

OBJECTIVE: To measure the plasma catecholamine concentrations during an episode of haemorrhagic shock treated by intraosseous infusion of a small volume of hyperosmotic fluid in a standardised porcine model. DESIGN: Randomised open study. SETTING: University hospital, Norway. MATERIAL: 14 piglets. INTERVENTION: Two groups of piglets (n=7 each) were anaesthetised with ketamine and bled to a mean arterial pressure of 40 mm Hg. After 30 minutes the animals were randomised to receive 100 ml of either hyperosmotic (2.4 mo/l) or iso-osmotic (0.29 mo/l) fluid (equal volumes of glucose and sodium chloride) into the tibial bone marrow. MAIN OUTCOME MEASURES: Short term (70 minutes) observation of changes in haemodynamic, biochemical and hormonal variables. RESULTS: The hyperosmotic infusion significantly improved the circulation (mean arterial pressure and cardiac index) compared with the iso-osmotic infusion (p < 0.05). The increased plasma catecholamine concentrations returned to the reference ranges 20 minutes after the hyperosmotic infusion, and were significantly different (p < 0.05) from the catecholamine concentrations observed in the iso-osmotic treatment group. CONCLUSION: Intraosseous hyperosmotic resuscitation increases the circulatory performance and reduces the plasma catecholamine concentrations during haemorrhagic shock in pigs.

Animals↗
PubMed1994

[Treatment of hypersecretory ileostomy, gastrostomy and fistula of the small intestine with the somatostatin analog octreotide].

Hypersecretory stomas or fistulas are disabling conditions for the patients and a therapeutic challenge to the surgeons. Octreotide treatment is reported to reduce stoma output and the need for intravenous supplements. Octreotide treatment also reduces social disability due to postprandial hypersecretion causing frequent changes of stoma systems. Two patients with high output stomas and one patient with high output ileocutaneous fistula were treated with the somatostatin analogue octreotide. Reductions in stoma or fistula output from 48 to 62% were observed.

Adult↗
PubMed1994

The effects of plasma and albumin infusion on organ function and sepsis markers in experimental gram-negative sepsis.

To study the effects of early plasma versus albumin infusion on vital organ function and the appearance of central sepsis mediators in septic shock, three groups of anesthetized piglets (n = 28) were inoculated with live Eschericia coli. Group I received fresh frozen plasma, group II received albumin, whereas group III served as nontreated septic controls. Plasma-treated animals exhibited improved survival (p < .02) compared with controls, and improved organ function compared with both controls and albumin-treated animals. Plasma infusion was associated with increased levels of endotoxin (p < .02) and terminal complement complex (TCC) (p < .03), and persisting high levels of tumor necrosis factor (TNF). Following albumin infusion TNF levels decreased to baseline values (p < .01), whereas endotoxin and TCC levels did not change significantly. Our study shows a beneficial effect of early plasma infusion on survival and vital organ function in septic animals. The effect of plasma infusion on circulating levels of endotoxin, TNF, and TCC may be potentially deleterious in uncompensated stages of septic shock.

Albumins↗
PubMed1993

Growth hormone treatment after abdominal surgery decreased carbohydrate oxidation and increased fat oxidation in patients with total parenteral nutrition.

Patients undergoing elective abdominal surgery were double-blindly randomized for treatment with growth hormone (GH) 24 IU (n = 9) or placebo (n = 10) the first 5 postoperative days while receiving total parenteral nutrition (nitrogen, 5.7 +/- .1 g/m2; energy, 1,018 +/- 12 kcal/m2, ie, 125% +/- .7% of basal metabolic rate [BMR]). Carbohydrate and fat metabolism were evaluated from indirect calorimetry, daily blood samples, and forearm substrate-flux studies. Hormone levels in plasma or blood were also determined. GH decreased carbohydrate oxidation, increased fat oxidation, and increased resting energy expenditure (REE). Free fatty acids (FFA), glycerol, and beta-hydroxybutyrate (beta-OH-B) levels increased in both arterial and venous plasma, and forearm release of FFA and glycerol increased. GH, insulin-like growth factor 1 (IGF-1), and glucagon levels in venous blood were also increased in GH-treated patients. Thus, GH induced mobilization and utilization of fat, and fat was preferred to glucose for energy requirements in patients after abdominal surgery with nutritional support.

Adult↗
PubMed1993

Growth hormone after abdominal surgery attenuated forearm glutamine, alanine, 3-methylhistidine, and total amino acid efflux in patients receiving total parenteral nutrition.

OBJECTIVE: The study clarified the effects of growth hormone treatment on forearm amino acid efflux in patients with full nutritional support after gastrointestinal surgery. SUMMARY BACKGROUND DATA: Growth hormone attenuates net nitrogen loss after surgical trauma. An increase in net protein synthesis has been described, whereas the results regarding protein breakdown have been conflicting. METHODS: Elective patients undergoing abdominal surgery were double blindly randomized to treatment with recombinant human growth hormone (GH, n = 9) 24 IU or placebo (PL, n = 10) the first 5 postoperative days. All received parenteral nutrition (nitrogen = 5.7 +/- .1 g/m2, energy = 1018 +/- 12 kcal/m2 (125 +/- .7% of BMR) and epidural analgesia. Amino acid plasma levels and forearm fluxes were measured. RESULTS: The second postoperative day, growth hormone abolished forearm efflux of total amino acid nitrogen (GH: 170 +/- 117, PL: -785 +/- 192 nmol/100 mL/min, p = .0007) due to reduced losses of both essential and nonessential amino acids. Glutamine release was abolished (13 +/- 15 vs. -137 +/- 43 nmol/100 mL/min, p = .007) and alanine release attenuated (-61 +/- 17 vs. -211 +/- 51 nmol/100 mL/min, p = .01). 3-Methyl-histidine release was attenuated (-.20 +/- .11 vs. -.62 +/- .09 nmol/100 mL/min, p = .04). Growth hormone also induced decreased venous plasma amino acid levels. CONCLUSIONS: When given after gastrointestinal surgery in patients treated with total parenteral nutrition, growth hormone treatment abolished glutamine, 3-methylhistidine, and total amino acid nitrogen loss from forearm tissue. Alanine loss from forearm tissue was attenuated.

Abdomen↗
PubMed1993

Fatal course in severe meningococcemia: clinical predictors and effect of transfusion therapy.

OBJECTIVE: To investigate whether the administration of fresh-frozen plasma to patients with systemic meningococcal disease is associated with an increased mortality rate compared with the administration of plasma substitutes. DESIGN: Seventeen-year case-control study. SETTING: Intensive care units and departments of internal medicine and pediatrics of one university hospital and one local hospital. PATIENTS: A total of 336 patients with culture-proven meningococcemia or symptoms characteristic of meningococcemia who were admitted to two hospitals in northern Norway between 1974 and 1991. MEASUREMENTS AND MAIN RESULTS: High-risk patients were selected on the basis of two different scoring systems (Niklasson's score and clinical score) and classified according to the type of intravenous fluid regimen (fresh-frozen plasma, blood, or colloids). For comparison between groups, analysis of variance and chi-square tests were used. Assessments of adjusted effects on mortality rate were done by multiple logistic regression. Administration of blood or plasma was significantly associated with a fatal course, both in the total patient population (p < .01) and in the high-risk group (p = .02), while using colloids alone was negatively associated with death, although not reaching statistical significance. A significantly lower mortality rate was found in one of the hospitals where colloids were used instead of plasma or blood in the last part of the period studied (p < .05). CONCLUSION: The results support our hypothesis that the use of fresh-frozen plasma may negatively influence outcome in systemic meningococcal disease.

Adolescent↗
PubMed1993

Growth hormone and surgery.

Growth hormone (GH) is a very potent anabolic agent released in the physiological situation in a pulsative manner from the pituitary gland. GH stimulates the protein synthesis and increases the intracellular transport of amino acids. When GH is administered to surgical patients, nitrogen retention is regularly seen, and in most situations fast mobilization takes place. The present data indicate that GH has a beneficial effect on the healing processes after surgery and trauma.

Abdomen↗
PubMed1993

Resuscitation of pigs with haemorrhagic shock by an intraosseous hyperosmotic solution and transfusion of autologous whole blood.

OBJECTIVE: To evaluate resuscitation after episodes of haemorrhagic shock by the combination of intraosseous infusion of a small volume of hyperosmotic fluid, followed by whole blood, in a standard experiment in pigs. DESIGN: Randomised open study. MATERIAL: 18 piglets. INTERVENTIONS: After a 60 minute period of stabilization all animals were bled to an arterial systolic pressure of 60 mm Hg. After 30 minutes 100 ml hyperosmotic fluid was given over a seven minute period into the tibial bone marrow (n = 6) or into an ear vein (n = 6). Ninety minutes later the animals were again bled to a systolic pressure of 60 mm Hg and 30 minutes after this they were treated by autologous blood transfusion either by intraosseous or intravenous infusion. Six animals acted as untreated controls. MAIN OUTCOME MEASURES: Changes in haemodynamic, haematological and biochemical variables. RESULTS: Two pigs in the control group died. There was no difference between the intraosseous and intravenous routes for the infusion of small volumes of hyperosmotic fluid or whole blood. There was a significant improvement in haemodynamic variables after resuscitation with intraosseous infusion of small volumes of hyperosmotic fluid (p < 0.05). CONCLUSION: Intraosseous infusions were easy to establish, and may be a useful method of resuscitation from haemorrhagic shock, particularly in children.

Animals↗
PubMed1993

Repeated plasma therapy induces fatal shock in experimental septicemia.

Plasma therapy in severe septicemia, either as part of plasma exchange or alone, was evaluated in a model of lethal septic shock induced with live Escherichia coli in pigs. The following groups were studied: group I, septic animals treated with repeated plasma exchanges, n = 8; group II, nontreated septic controls, n = 8; group III, septic animals treated with repeated plasma infusions, n = 14; and group IV, nonseptic animals treated with repeated plasma infusions, n = 7. In the septic animals treated with plasma (groups I and III), a rapid fatal response was observed between 2 and 5 min after the start of plasma therapy, while the septic controls (group II) showed a progressively longer lasting septic shock. The nonseptic animals (group IV) were unaffected by the plasma infusions. Plasma levels of endotoxin above 2 ng/ml were associated with rapid death during plasma therapy. Ionized Ca2+ fell abruptly in this situation. This study indicates that commonly used plasma therapies (exchanges or transfusions) in septic animals may have acute deleterious effects. These effects may be explained by depletion of ionized calcium.

Acid-Base Equilibrium↗
PubMed1992

Effects of in vivo endotoxin infusions on in vitro cellular immune responses in humans.

Studies of the immune response of patients following major injury have identified significant abnormalities, some of which may be due to the effects of endotoxin. To evaluate the effect of endotoxin on the immune system without conflicting variables, we studied 18 normal, healthy male volunteers each on two occasions. In one study, Escherichia coli endotoxin was administered intravenously at a dose of 4 ng/kg. In the other, saline was given. Blood for immune function studies was obtained at either 0, 4, or 24 hr (seven volunteers), 0, 1, and 4 hr (five volunteers), or 0, 4, and 6 hr (six volunteers) postinfusion. Peripheral blood mononuclear cells (PBMC) were isolated and adjusted to the same concentration. Measurements following endotoxin infusion were compared with those of the same volunteers following saline infusion and with those from normal ambulatory laboratory volunteers. Interleukin 1 (IL-1) production by adherent cells was significantly reduced at 1 hr post endotoxin infusion. Significant decreases in number of mononuclear cells, response to phytohemagglutinin (PHA), and production of IL-2 and IL-1 were observed by 4 hr after endotoxin infusion. No significant changes in percentages of monocytes, lymphocytes, or CD3, CD4, or CD8 lymphocytes were observed at any time. By 24 hr postinfusion all values had returned to normal or, in some cases, supranormal levels. Response to PHA by PBMC from volunteers 4 hr following endotoxin was completely restored by in vitro addition of recombinant human IL-2 but was only marginally improved by IL-1. In vitro addition of indomethacin to PBMC cultures responding to PHA reduced the suppression observed after in vivo endotoxin but also was not as effective as IL-2. In a fourth study, seven volunteers were treated as above either with two doses (800 mg each) of the cyclooxygenase inhibitor ibuprofen before endotoxin infusion or with ibuprofen alone. Ibuprofen pretreatment completely restored the PBMC response to PHA to normal and caused a significant decrease in the endotoxin-induced suppression of IL-2 production. However, the decrease in circulating PBMC number and adherent cell secretion of IL-1 was not affected by inhibition of the cyclooxygenase pathway. These results suggest that endotoxin has immunomodulatory effects on both adherent mononuclear-cell and T-lymphocyte function and that more than one mechanism is involved.

Adult↗
PubMed1992

Pre- and postoperative glucose levels for eliciting hypoglycaemic responses in a patient with insulinoma.

Counterregulatory hormones and hypoglycaemic symptoms were studied during a gradual decline in plasma glucose in a 66-year-old man before and 9 weeks after removal of an insulin-producing tumour. Before surgery the adrenaline started to respond first at plasma glucose 2.8 mmol l-1. He reported no autonomic symptoms although plasma glucose fell to 2.3 mmol l-1 with a corresponding adrenaline rise to 4.64 nmol l-1. After surgery adrenaline responded at a plasma glucose of 3.7 mmol l-1 and he started to sweat and tremble at a plasma glucose of 3.1 mmol l-1 (corresponding adrenaline 2.63 nmol l-1). The lack of autonomic symptoms preoperatively may indicate adrenaline insensitivity, possibly as a result of repeated hypoglycaemia.

Aged↗
PubMed1991

Tumor necrosis factor and interleukin 1 appearance in experimental gram-negative septic shock. The effects of plasma exchange with albumin and plasma infusion.

To study the effect of plasma removal vs plasma administration on the appearance of tumor necrosis factor (TNF) and interleukin 1 in septic shock, 24 anesthetized piglets were inoculated with live Escherichia coli. Plasma exchange with albumin was performed in one group. Fresh-frozen plasma was administered to a second group. A third group served as nontreated controls. Following plasma exchange, a reduction in both TNF and interleukin 1 levels occurred, whereas plasma infusion was followed by a decrease in TNF levels only. No significant differences were observed between the two treated groups with respect to survival or cardiovascular performance, with both being significantly enhanced compared with the controls. High levels of TNF and interleukin 1 correlated with depressed cardiovascular performance in the early phase of the shock. Our results confirm the important role of TNF and interleukin 1 as early mediators of septic shock. However, the benefit of reducing cytokine activity in later stages of septicemia seems to be dubious.

Animals↗
PubMed1991

Nitrogen retention caused by growth hormone in patients undergoing gastrointestinal surgery with epidural analgesia and parenteral nutrition.

Nineteen patients undergoing elective gastrointestinal surgery were randomised to receive recombination human growth hormone (n = 9) or placebo (n = 10) for the first five postoperative days. All received epidural analgesia and total parenteral nutrition during the same period (energy supply 125% of basal metabolic rate, mean nitrogen (+/- SEM) 5.7 (+/- 0.1) g/m2). Nitrogen and potassium retention was induced in the growth hormone group compared with the placebo group (cumulative nitrogen balance 4.1 (+/- 1.1) g/m2 in the growth hormone group and -3.1 (+/- 1.8) g/m2 in the placebo group, p less than 0.01; cumulative potassium balance 80.8 (+/- 4.7) mmol/m2 in the growth hormone group and 43.1 (+/- 11.4) mmol/m2 in the placebo group, p less than 0.01). In the growth hormone group, serum glucose concentrations increased each evening and mean serum albumin concentrations were reduced throughout the period; the morning pulse rates were decreased, and the patients gained weight compared with the placebo group.

Adult↗
PubMed1990

Continuous removal of leucocytes during early gram-negative septicemia reduces plasma levels of endotoxin and improves cardiac performance.

The effect of filter leucapheresis as treatment of gram-negative septicemia was studied in an experimental porcine model. In 7 matched pairs of animals, one of the animal groups received filter leucapheresis starting 2 h after the induction of septicemia. The other animal group acted as a non-treated control. A calculated mean number of 15 x 10(9) white blood cells were removed. Animals submitted to leucapheresis showed lower levels of circulating endotoxin, diminished degree of granulocyte activation and higher cardiac output when compared to the non-treated controls. The increased cardiovascular performance indicated a beneficial effect of selective leucafiltration during early gram-negative septicemia. Lower levels of circulating endotoxin and less active PMNs might contribute to these changes.

Animals↗
PubMed1990

Both cyclooxygenase-dependent and cyclooxygenase-independent pathways mediate the neuroendocrine response in humans.

The neuroendocrine response that occurs after operation, trauma, or infection is essential for maintaining homeostasis within the host. Corticotropin-releasing hormone, (CRH), arginine vasopressin (AVP), and products of the cyclooxygenase pathway have been proposed as possible mediators of the pituitary-adrenal response. We studied the relationship between the induction of these mediators and the onset of the neuroendocrine response in healthy male volunteers receiving one of two standard provocative stimuli: (1) Escherichia coli endotoxin (4 ng/kg intravenously) and (2) hypoglycemia induced by insulin (0.15 units/kg intravenously). Additional subjects receiving these stimuli were pretreated with the cyclooxygenase inhibitor ibuprofen, 1600 mg orally. Serial measurements were made of circulating concentrations of CRH, AVP, adrenocorticotropic hormone, cortisol, and catecholamines. A sudden rise in circulating AVP (but not CRH) concentrations preceded the onset of all other responses after both stimuli. The prevention of this surge of AVP after endotoxin by ibuprofen was associated with blockade of the neuroendocrine response. These data demonstrate that two independent pathways are available for stimulation of the stress response. After both stimuli, peripheral AVP (but not CRH) levels may mirror alterations that occur within the central nervous system.

Adult↗
PubMed1989

[Gastrointestinal myoelectric activity].

Gut motility research is a field where rapid progress is being made. We expect that, in future, diagnosis and treatment of motility disorders will become an important part of gastroenterology. Various techniques are now available for studying motility. This paper reviews one of them, namely recording and interpreting gastrointestinal myoelectric activity.

Gastrointestinal Motility↗